Crowdsourcing Humanitarian Innovation

The cover of a recent issue of Parade magazine featured a photo of a girl with a bright blue prosthetic hand. The accompanying article was titled, “How 3-D Printing is Transforming Everything from Medicine to Manufacturing.” The writer noted that the girl’s Robohand cost “just $2,000.”

For many people around the globe, $2,000 might as well be $2 million. Fortunately, there’s e-NABLE, a nonprofit organization that exists at the intersection of ingenuity, innovation, and patient care. On a gorgeous fall Sunday in September, more than 400 people gathered at Johns Hopkins Hospital in Baltimore to talk about how they could help get prosthetics to underserved populations, especially children. I was lucky enough to be there.

e-NABLE was founded by Jon Schull, a research scientist at the Center for Media, Arts, Games, Interaction & Creativity (MAGIC) at the Rochester Institute of Technology. I saw him speak at Stanford MedX in early September. [You can see a version of that talk here.] The e-NABLE community connects people with 3D printers to children in need of prosthetic hands. Upper-limb differences, as they are called, affect one in two thousand children.

The effort began simply: a 20-minute experiment with a Google map, Schull says. He created a Google Plus community—“a distributed pay-it-forward network”–that numbered 2,040 in September and was growing at 10 percent a week. The e-NABLE community brings together kids, their parents, amateur designers, and professional prosthetists to produce hands that are tailored to kids’ designs and inexpensive—averaging $50. Open-source software, Hand-o-matic, is available free of charge. People and facilities with 3-D printers volunteer for the production end.

e-NABLE hit a “cosmic sweet spot,” as Schull terms it, living at the confluence of electronic communication, technology, and goodwill. It provides a choice between peanut butter and caviar. While “caviar” prosthetics are available that cost $2,000, or $20,000, “There are a lot of kids out there who just want peanut butter,” he says.

It’s way more than plain peanut butter, though. Involving the kids in customizing designs unleashes their creativity and generates prosthetics that make them feel like superheroes. We heard about kids who requested glow-in-the-dark plastic, extra-long arms for reaching high shelves, and hands with two thumbs. A recent article in The Atlantic recounts the story of a boy who worked with a designer to design a hand that can hold a Wii controller or a violin bow.

The conference was hosted by Albert Chi, MD, MS, FACS, assistant professor and director of acute care surgery at Johns Hopkins Hospital. He and his students in Johns Hopkins’ Applied Physics Lab have been doing research in advanced prosthetics that now includes 3-D printing. The involvement with e-NABLE has been great for his students, he says.

“The students have been exposed to an incredible philanthropic movement. They are really involved, and are getting to see the psychosocial benefits to the children of the hands they create,” Chi says.

Thus far, the JHU team has built 12 hands using five different designs. They continue to modify and improve the designs, such as integrating a below-the-elbow design with a shoulder harness and designing a swimming fin. It takes about eight to 12 hours to print and eight hours to assemble a finished hand.

“Three-D printing embraces the ideals of cutting-edge technology as it makes a historic impact on people’s lives. This field attracts people who are brilliant and dedicated to serving others, shares the privilege of working with patients, and enriches with friendship and courage, “ Chi says.

The partnership between e-NABLE and health care researchers and providers is crucial, Schull says. “We are under no illusion that we are medical professionals. We need their help and guidance to make sure the devices do no harm and to scale up new designs. In return, medical professionals will have inexpensive devices to add to the range of options that they can present to their patients.”

The Atlantic article concludes, “Few children with upper-limb loss have access to a 3-D printer.” However, one speaker at the September event noted that 1 billion people on earth live within 10 miles of a 3-D printer. Thanks to e-NABLE and its “distributed manufacturing” approach, even geography is no barrier.

Jennifer J. Salopek is founding editor of Wing of Zock. Email her at jsalopek@aamc.org or follow her on Twitter @jsalopek.